scholarly journals Accuracy assessment of measuring component position after total ankle arthroplasty using a conventional method

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Kyoung-Jai Lee ◽  
Shao-Hua Wang ◽  
Gun-Woo Lee ◽  
Keun-Bae Lee
Keyword(s):  
Conventional Method ◽  
Accuracy Assessment ◽  
Total Ankle Arthroplasty ◽  
Component Position ◽  
Ankle Arthroplasty

scholarly journals Influence of Tibial Component Position on Altered Kinematics Following Total Ankle Arthroplasty During Simulated Gait

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0010
Author(s):  
Guilherme Saito ◽  
Daniel Sturnick ◽  
Jonathan Deland ◽  
Scott Ellis ◽  
Constantine Demetracopoulos
Keyword(s):  
Ankle Joint ◽  
Tibial Component ◽  
Joint Kinematics ◽  
Transverse Plane ◽  
Total Ankle Arthroplasty ◽  
Component Position ◽  
Ankle Arthroplasty ◽  
Ankle Kinematics ◽  
Joint Contact

Category: Ankle Arthritis Introduction/Purpose: Correct positioning of total ankle arthroplasty (TAA) implants has been associated with superior clinical outcomes. Furthermore, biomechanical studies have demonstrated that poor alignment of the components may lead to early component wear, compromising the longevity of the prosthesis. Malpositioning of TAA implants affects ligament engagement patterns and joint contact mechanics, possibly leading to altered joint kinematics. However, the correlation between implant position and ankle joint motion is still unclear. The objective of this study was to assess the effect of tibial component position on ankle kinematics following TAA during simulated gait. Methods: Eight mid-tibia cadaveric specimens were utilized in this IRB approved study. The stance phase of gait was simulated both pre- and post-TAA in each specimen using a six-degree of freedom robotic platform. Ground reaction forces and tibial kinematic from in vivo data were replicated while physiologic tendon force profiles were applied to each extrinsic ankle tendons by linear actuators instrumented. Ankle kinematics was measured from reflective markers attached to bones via surgical pins. TAAs were completed using a common fixed-bearing total ankle system following the manufacturer recommended protocol (Salto Talaris, Integra LifeSciences). Using reconstructed CT data, 3D tibial component position relative to a standard ankle joint reference was characterized (Figure 1A). The effect of tibial component position on absolute differences in ankle kinematics (pre – post TAA) was assessed using linear regression with a level of significance set to p = 0.05. Results: Differences in ankle joint kinematics were only identified in the transverse plane, where internal talar rotation was significantly increased following TAA compared to the native condition (Figure 1B). The medial position of TAA tibial components was found to be positively associated with increased internal talar rotation (Figure 1C; β = 1.861 degrees/mm, R2 = 0.72, p = 0.008). No other measurements of tibial component position (anterior-posterior/inferior-superior position, sagittal/frontal/transverse plane angle) were found to be significantly associated with altered ankle kinematics following TAA (All β < 0.1 and p > 0.05). Conclusion: This study suggests that medial positioning of the tibial implant affects ankle kinematics. During operative procedures the tibial component is usually positioned in order to preserve bone stock of the medial and lateral malleolus. However, little attention is given to the position of the implant in relation to the center of the tibial axis. This finding could have clinical implications for techniques implemented during surgical procedures and for the development of new instrumentation systems.

Influence of Tibial Component Position on Altered Kinematics Following Total Ankle Arthroplasty During Simulated Gait

2019 ◽  
Vol 40 (8) ◽  
pp. 873-879 ◽  
Author(s):  
Guilherme H. Saito ◽  
Daniel R. Sturnick ◽  
Scott J. Ellis ◽  
Jonathan T. Deland ◽  
Constantine A. Demetracopoulos
Keyword(s):  
Tibial Component ◽  
Lateral Position ◽  
Plane Motion ◽  
Joint Kinematics ◽  
Transverse Plane ◽  
Total Ankle Arthroplasty ◽  
Implant Design ◽  
Component Position ◽  
Ankle Arthroplasty ◽  
Ankle Kinematics

Background: Ankle and hindfoot kinematics following total ankle arthroplasty (TAA) are poorly understood and it is unclear whether patients can replicate physiologic motion after TAA. Furthermore, the effect of implant position on TAA kinematics is unknown. The objective of this study was to compare ankle and hindfoot kinematics pre- and post-TAA during simulated gait and determine to what degree tibial component position correlated with variations in ankle kinematics. Methods: Eight midtibia cadaveric specimens were utilized in this institutional review board–approved study. The stance phase of gait was simulated both pre- and post-TAA in each specimen using a 6 degrees of freedom robotic platform. Ankle and hindfoot kinematics were measured from reflective markers attached to bones via surgical pins. The effect of tibial component position on absolute differences in ankle kinematics was assessed using linear regression. Results: No differences were observed in ankle sagittal and coronal plane motion between the intact and TAA conditions. Differences in ankle joint kinematics were identified in the transverse plane, where internal talar rotation was significantly increased following TAA compared with the native condition. The medial-lateral position of the tibial component was found to correlate with the altered transverse plane motion observed after TAA (β = 1.861 degrees/mm, R2 = 0.72, P = .008). No significant differences in subtalar and talonavicular joint kinematics in any plane were observed comparing the pre- and post-TAA condition. Conclusion: This study demonstrated an increased internal rotation of the ankle in the transverse plane following TAA. This increase was correlated with the medial-lateral position of the tibial implant. Clinical Relevance: This finding could have clinical implications for how tibial components are positioned during the operative procedure, and how implant design and position may affect ankle kinematics following TAA.

scholarly journals TL 18049 - Influence of tibial component position on altered kinematics following total ankle arthroplasty during simulated gait

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 63S
Author(s):  
Guilherme Honda Saito ◽  
Daniel Sturnick ◽  
Jonathan Deland ◽  
Scott Ellis
Keyword(s):  
Ankle Joint ◽  
Tibial Component ◽  
Degrees Of Freedom ◽  
Lateral Position ◽  
Total Ankle Arthroplasty ◽  
Component Position ◽  
Ankle Arthroplasty ◽  
Ankle Motion ◽  
Ankle Kinematics ◽  
Ct Data

Introduction: Correct positioning of total ankle arthroplasty (TAA) implants has been associated with superior clinical outcomes. However, the correlation between implant position and ankle motion is unclear. The objective of this study was to assess the effect of tibial component position on ankle kinematics during simulated gait. Methods: The stance phase of gait was simulated pre and post-TAA with 8 mid-tibia cadaveric specimens using a six-degrees-of-freedom robotic platform. Ankle kinematics were measured based on reflective markers. A fixed-bearing total ankle system (Salto Talaris, Integra LifeSciences) was used. Using reconstructed CT data, the 3D tibial component position relative to a standard ankle joint reference was characterized (Fig 1A). The effect of the tibial component position on absolute differences in ankle kinematics (pre/post TAA) was assessed using linear regression with a level of significance set to p = 0.05. Results: Differences in ankle joint kinematics were only identified in the transverse plane, where internal talar rotation was significantly increased following TAA compared with the native condition (Fig 1B). The medial position of TAA tibial components was positively associated with increased internal talar rotation (Fig 1C; β = 1.861 degrees/mm, R2 = 0.72, p = 0.008). Conclusion: This study suggests that a medial-lateral position of the tibial implant affects ankle kinematics. During operative procedures, the tibial component is usually positioned to preserve the bone stock of the medial and lateral malleolus. However, little attention is given to the position of the implant in relation to the center of the tibial axis. This finding could have clinical implications for techniques.

Does Intra-articular Injection of the Ankle With Corticosteroids Increase the Risk of Subsequent Periprosthetic Joint Infection (PJI) Following Total Ankle Arthroplasty (TAA)? If So, How Long After a Prior Intra-articular Injection Can TAA Be Safely Performed?

2019 ◽  
Vol 40 (1_suppl) ◽  
pp. 3S-4S
Author(s):  
Ilker Uçkay ◽  
Christopher B. Hirose ◽  
Mathieu Assal
Keyword(s):  
Periprosthetic Joint Infection ◽  
Corticosteroid Injection ◽  
Joint Infection ◽  
Invasive Procedure ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Strong Consensus ◽  
Healthcare Associated ◽  
The Ideal

Recommendation: Every intra-articular injection of the ankle is an invasive procedure associated with potential healthcare-associated infections, including periprosthetic joint infection (PJI) following total ankle arthroplasty (TAA). Based on the limited current literature, the ideal timing for elective TAA after corticosteroid injection for the symptomatic native ankle joint is unknown. The consensus workgroup recommends that at least 3 months pass after corticosteroid injection and prior to performing TAA. Level of Evidence: Limited. Delegate Vote: Agree: 92%, Disagree: 8%, Abstain: 0% (Super Majority, Strong Consensus)

The Effect of Patient Characteristics on 1 to 2-Year and Minimum 5-Year Outcomes After Total Ankle Arthroplasty

2019 ◽  
Vol 101 (3) ◽  
pp. 199-208 ◽  
Author(s):  
Daniel J. Cunningham ◽  
James K. DeOrio ◽  
James A. Nunley ◽  
Mark E. Easley ◽  
Samuel B. Adams
Keyword(s):  
Patient Characteristics ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthroplasty

Midfoot Function Before and After Total Ankle Arthroplasty

2021 ◽  
pp. 107110072199578
Author(s):  
Frank E. DiLiberto ◽  
Steven L. Haddad ◽  
Steven A. Miller ◽  
Anand M. Vora
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Peak Power ◽  
Nonparametric Tests ◽  
Total Ankle Arthroplasty ◽  
Control Group ◽  
Ankle Arthroplasty ◽  
First Metatarsal ◽  
Before And After

Background: Information regarding the effect of total ankle arthroplasty (TAA) on midfoot function is extremely limited. The purpose of this study was to characterize midfoot region motion and power during walking in people before and after TAA. Methods: This was a prospective cohort study of 19 patients with end-stage ankle arthritis who received a TAA and 19 healthy control group participants. A motion capture and force plate system was used to record sagittal and transverse plane first metatarsal and lateral forefoot with respect to hindfoot motion, as well as sagittal plane midfoot region positive and negative peak power during walking. Parametric or nonparametric tests to examine differences and equivalence across time were conducted. Comparisons to examine differences between postoperative TAA group and control group foot function were also performed. Results: Involved-limb midfoot function was not different between the preoperative and 6-month postoperative time point in the TAA group (all P ≥ .17). Equivalence testing revealed similarity in all midfoot function variables across time (all P < .05). Decreased first metatarsal and lateral forefoot motion, as well as positive peak power generation, were noted in the TAA group postoperative involved limb in comparison to the control group (all P ≤ .01). Conclusion: The similarity of midfoot function across time, along with differences in midfoot function in comparison to controls, suggests that TAA does not change midfoot deficits by 6 months postoperation. Level of Evidence: Level II, prospective cohort study.

30-Day Outcomes for Total Ankle Arthroplasty in Patients With Anemia

2021 ◽  
pp. 107110072110175
Author(s):  
Jordan R. Pollock ◽  
Matt K. Doan ◽  
M. Lane Moore ◽  
Jeffrey D. Hassebrock ◽  
Justin L. Makovicka ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Univariate Analysis ◽  
Hospital Length ◽  
Total Ankle Arthroplasty ◽  
Hospital Length Of Stay ◽  
Preoperative Anemia ◽  
Improvement Project ◽  
Average Hospital ◽  
Ankle Arthroplasty ◽  
Reoperation Rates

Background: While anemia has been associated with poor surgical outcomes in total knee arthroplasty and total hip arthroplasty, the effects of anemia on total ankle arthroplasty remain unknown. This study examines how preoperative anemia affects postoperative outcomes in total ankle arthroplasty. Methods: A retrospective analysis was performed using the American College of Surgeons National Surgery Quality Improvement Project database from 2011 to 2018 for total ankle arthroplasty procedures. Hematocrit (HCT) levels were used to determine preoperative anemia. Results: Of the 1028 patients included in this study, 114 patients were found to be anemic. Univariate analysis demonstrated anemia was significantly associated with an increased average hospital length of stay (2.2 vs 1.8 days, P < .008), increased rate of 30-day readmission (3.5% vs 1.1%, P = .036), increased 30-day reoperation (2.6% vs 0.4%, P = .007), extended length of stay (64% vs 49.9%, P = .004), wound complication (1.75% vs 0.11%, P = .002), and surgical site infection (2.6% vs 0.6%, P = .017). Multivariate logistic regression analysis found anemia to be significantly associated with extended hospital length of stay (odds ratio [OR], 1.62; 95% CI, 1.07-2.45; P = .023) and increased reoperation rates (OR, 5.47; 95% CI, 1.15-26.00; P = .033). Anemia was not found to be a predictor of increased readmission rates (OR, 3.13; 95% CI, 0.93-10.56; P = .066) or postoperative complications (OR, 1.27; 95% CI, 0.35-4.56; P = .71). Conclusion: This study found increasing severity of anemia to be associated with extended hospital length of stay and increased reoperation rates. Providers and patients should be aware of the increased risks of total ankle arthroplasty with preoperative anemia. Level of Evidence: Level III, retrospective comparative study.

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